Topics in Geriatrics: Short-Form 36 (SF-36) Assessment Tool
Objectives:
1.Describe the SF-36 2.Discuss who could use the SF-36 3.Provide evidence regarding the SF-36 4.Summarize key points
Description of the SF-36:
“The Medical Outcomes Study Short-Form General Health Survey (SF-36) is a self-reported multidimensional measure of general health status or quality of life. It produces eight scales of health status: physical functioning, role limitation caused by physical health problems, bodily pain, general health perceptions, vitality for energy levels and fatigue, social functioning, role limitation because of emotional problems and mental health. Lower scores on these scales reflect poorer health (Mishra, Gita D. et al., 2011).” Rehabmeasures.com: The SF-36 contains 36 items divided into 8 subscales and 2 composite domains
The 8 subscales are:
(1) Physical Functioning
(2) Role Limitations due to Physical Problems
(3) General Health Perceptions
(4) Vitality
(5) Social Functioning
(6) Role Limitations due to Emotional Problems
(7) General Mental Health
(8) Health Transition
Respondents are asked to answer items referring to the past 4 weeks
Recommended scoring system for the SF-36 is a weighted Likert system for each item
Items within subscales are totaled to provide a summed score for each subscale or dimension.
Each of the 8 summed scores is linearly transformed onto a scale from 0 (negative health) to 100 (positive health) to provide a score for each subscale. Each subscale can be used independently.
For each domain (physical and mental composite) mean score = 50 and standard deviation = 10
Time to administer: 10 minutes; 41 and 47 minutes, respectively, for individuals with paraplegia & tetraplegia (Anderson, et al 1999)
Who this outcome should be used with and evidence to support: A study by Gita D. et al. found that the SF-36 is sufficient and reliable to be used as a measure of health-related quality of life in the older adult population. (The study had over 2,000 participants in 3 cohorts with a mean age between 64-76 years) The SF-36 is appropriate for use in patients with MS who are not currently in the acute care, inpatient, or skilled nursing facility settings. So outpatient and home health are good. Because the SF-36 is a self-reported measure, it is NOT appropriate for patients with dementia. Considerations from Rehab Measures website:
“Physical function domain: significant floor effects for patients with SCI and other disabilities due to inability to perform some of the physical tasks described. Recommend the SF-36 state “walkwheel” to improve responsiveness for patients with spinal cord injury. (Lee et al., 2009)” “Not recommended for:
Patients who cannot understand written or spoken language
Severely affected stroke survivors who require a proxy to complete the assessment
To document patient change (Dorman et al., 1999)
Some disadvantaged populations, slight declines in reliability may result (Turner-Bowker et al., 2002)”
“Postal administration of the SF-36 is not recommended (O'Mahony et al, 1998).” Populations Tested: The following conditions each have 50 or more publications (Turner-Bowker et al, 2002):
Arthritis
Back pain
Cancer of the Head & Neck
Low back pain
Multiple sclerosis
Musculoskeletal conditions
Neuromuscular conditions
Osteoarthritis
Parkinson Disease
Rheumatoid arthritis
Spinal injuries
Stroke
Trauma
Traumatic Brain Injury (Nichol et al, 2011)
Summary:
*SF-36 is reliable, valid, and shows consistency as a health status, quality of life outcome measure. *SF-36 can be used for geriatric patients, patients with MS, and the general population. *SF-36 is not recommended for patients with cognitive impairments because it is a self-reported measure (acute stroke, TBI, dementia, and others).
Topics in Geriatrics: Short-Form 36 (SF-36) Assessment Tool
Objectives:
1. Describe the SF-362. Discuss who could use the SF-36
3. Provide evidence regarding the SF-36
4. Summarize key points
Description of the SF-36:
“The Medical Outcomes Study Short-Form General Health Survey (SF-36) is a self-reported multidimensional measure of general health status or quality of life. It produces eight scales of health status: physical functioning, role limitation caused by physical health problems, bodily pain, general health perceptions, vitality for energy levels and fatigue, social functioning, role limitation because of emotional problems and mental health. Lower scores on these scales reflect poorer health (Mishra, Gita D. et al., 2011).”Rehabmeasures.com: The SF-36 contains 36 items divided into 8 subscales and 2 composite domains
Who this outcome should be used with and evidence to support:
A study by Gita D. et al. found that the SF-36 is sufficient and reliable to be used as a measure of health-related quality of life in the older adult population. (The study had over 2,000 participants in 3 cohorts with a mean age between 64-76 years)
The SF-36 is appropriate for use in patients with MS who are not currently in the acute care, inpatient, or skilled nursing facility settings. So outpatient and home health are good.
Because the SF-36 is a self-reported measure, it is NOT appropriate for patients with dementia.
Considerations from Rehab Measures website:
“Physical function domain: significant floor effects for patients with SCI and other disabilities due to inability to perform some of the physical tasks described. Recommend the SF-36 state “walkwheel” to improve responsiveness for patients with spinal cord injury. (Lee et al., 2009)”
“Not recommended for:
- Patients who cannot understand written or spoken language
- Severely affected stroke survivors who require a proxy to complete the assessment
- To document patient change (Dorman et al., 1999)
- Some disadvantaged populations, slight declines in reliability may result (Turner-Bowker et al., 2002)”
“Postal administration of the SF-36 is not recommended (O'Mahony et al, 1998).”Populations Tested:
The following conditions each have 50 or more publications (Turner-Bowker et al, 2002):
Summary:
*SF-36 is reliable, valid, and shows consistency as a health status, quality of life outcome measure.*SF-36 can be used for geriatric patients, patients with MS, and the general population.
*SF-36 is not recommended for patients with cognitive impairments because it is a self-reported measure (acute stroke, TBI, dementia, and others).
References:
Mishra, Gita D. et al. “How Useful Are the SF-36 Sub-Scales in Older People? Mokken Scaling of Data from the HALCyon Programme.” Quality of Life Research 20.7 (2011): 1005–1010. PMC. Web. 20 May 2017.__http://www.rehabmeasures.org/Lists/RehabMeasures/PrintView.aspx?ID=930__ 9/20/2015.
__https://www.rand.org/health/surveys_tools/mos/36-item-short-form/survey-instrument.html__
__https://www.rand.org/health/surveys_tools/mos/36-item-short-form/scoring.html__
Lenardt MH, Carneiro NHK, Binotto MA, Willig MH, Lourenço TM, Albino J. Frailty and quality of life in elderly primary health care users. Rev Bras Enferm [Internet]. 2016;69(3):448-53. DOI: http://dx.doi.org/10.1590/0034-7167.2016690309i. __https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=2&ved=0ahUKEwjv9P_I0_TTAhVM72MKHVBaD4kQFggoMAE&url=https%3A%2F%2Fwww.researchgate.net%2Ffile.PostFileLoader.html%3Fid%3D555c71946225ff25e98b4636%26assetKey%3DAS%253A273780436340737%25401442285750111&usg=AFQjCNHaSXbTQYbdJZw4Wq1FEUGddQl5Tw&sig2=l-oE_qULj4dtDxfqwZiFEg__
__http://eds.a.ebscohost.com.courseinfo.wssu.edu:2048/ehost/pdfviewer/pdfviewer?sid=3e995efe-d328-417a-8f9d-01bc22d9e727%40sessionmgr4010&vid=0&hid=4108__
Anderson, C., Laubscher, S., et al. (1996). "Validation of the Short Form 36 (SF-36) health survey questionnaire among stroke patients." Stroke 27: 1812-1816. __http://stroke.ahajournals.org/content/27/10/1812.long__
Banks, P. and Martin, C. R. (2009). "The factor structure of the SF-36 in Parkinson's disease." J Eval Clin Pract 15(3): 460-463. __http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2753.2008.01036.x/full__
Findler, M., Cantor, J., et al. (2001). "The reliability and validity of the SF-36 health survey questionnaire for use with individuals with traumatic brain injury." Brain Inj 15(8): 715-723. (Supplementary)
Dorman, P. J., Dennis, M., et al. (1999). "How do scores on the EuroQol relate to scores on the SF-36 after stroke?" Stroke 30: 2146-2151.
Andresen, E. M., Fouts, B. S., et al. (1999). "Performance of health-related quality-of-life instruments in a spinal cord injured population." Archives of physical medicine and rehabilitation 80(8): 877.
O'Mahony, P. G., Rodgers, H., et al. (1998). "Is the SF-36 suitable for assessing health status of older stroke patients?" Age Ageing 27: 19-22.
Turner-Bowker, D., Bartley, P., et al. (2002). "SF-36® Health Survey & “SF” Bibliography:(1988–2000)." Lincoln, RI: Quality Metric Incorporated.